Background/Purpose: Polymyalgia rheumatica (PMR) incidence peaks in individuals between 70 and 80 years of age; this same group is also at increased risk of complications and mortality related to COVID-19 infection. Vaccination against SARS-CoV2 is an essential tool in combatting COVID-19. There have been several case reports of PMR following vaccination with mRNA SARS-CoV2 vaccines.

The aim of this study was to identify patients with temporal association between mRNA SARS-CoV2 vaccination and PMR onset and to compare characteristics and disease course to those with new onset PMR without temporal association with SARS CoV2 vaccine exposure.

Methods: We conducted a retrospective chart review of all newly diagnosed PMR patients in a single center. Using ICD-10 codes, our EMR was queried to identify patients with newly diagnosed PMR beginning in December 2020, when the first SARS-CoV-2 vaccines were available in the US. Charts were reviewed for demographic information, disease characteristics and vaccination details. Patients who developed onset of PMR symptoms within 6 weeks after vaccination were compared to those whose PMR symptoms occurred without temporal association to vaccination. When available data at 6 and 12 months following diagnosis was collected.

Results: Eighty patients with newly diagnosed PMR between 12/1/2020 and 12/31/2021 were identified. There were 60 patients with new PMR without a temporal association to vaccination who were compared to 20 patients who developed PMR symptoms within 6 weeks of vaccination. Baseline demographics did not differ between the two groups. In the 20 cases with PMR onset after vaccination, symptoms developed a mean 38 days (IQR 19.5-48) after first dose of vaccine and 11.5 days (IQR 1-22) after second dose. There were no differences in baseline demographics, glucocorticoid dosages or relapse rates at 6 and 12 months following diagnosis. There was no association between vaccine manufacturer and PMR onset after vaccination (TABLE 1)

Conclusion: In this cohort, patients with onset of PMR within 6 weeks following mRNA vaccination against SARSCoV2 were similar to patients with de novo PMR at diagnosis, with no significant differences in disease course over the first 12 months. This does not support the notion that PMR following vaccination is a unique disease entity. The recognition of new PMR onset following SARS CoV2 vaccine may be coincidental in this common inflammatory disorder in a population with high rates of vaccine exposure.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/polymyalgia-rheumatica-following-sarscov-2-vaccination-a-single-center-cohort-study/